For some time now, I have been contemplating the kinds of questions we ask in health professions education (HPE). These ruminations began in 2010 when I was working on a paper about my medical school’s efforts to implement an educational innovation. Truth be told, I had a real problem. My study was supposed to be an evaluation of the innovation’s implementation; however, the data highlighted all the workarounds we constructed to make the innovation fit within our contextual constraints. How could I evaluate our implementation of the innovation when I was no longer confident that what we had implemented was still an exemplar of the original innovation?I found myself asking questions like: Why do we value this innovation? Why is our implementation an example of the innovation at work? How much can I change the innovation before I turn it into something else?

I started searching the literature to find insights into these questions. Surely other HPE scholars have had similar concerns. Surely I would not be the first to venture down this rabbit hole. Right